Bethany Cupp
Roanoke,VA
Summary
Dynamic Claims Representative with a proven track record at Elevance Health, excelling in claims investigation and claims processing. Recognized for enhancing efficiency through effective team communication and critical thinking. Skilled in data entry and analyzing claims, I streamlined workflows, reducing claim resolution times significantly while fostering teamwork and professionalism in a fast-paced environment.
Overview
6
6
years of professional experience
Work History
Claims Representative
Elevance Health
01.2023 - Current
- Processed and resolved claims inquiries, ensuring compliance with company policies and procedures.
- Evaluated claim submissions for accuracy, identifying discrepancies and initiating necessary follow-ups.
- Collaborated with internal teams to streamline claims processing workflows and enhance efficiency.
- Documented claim information accurately using proprietary systems to maintain comprehensive records.
- Assisted in training new staff on claims protocols, fostering a supportive learning environment.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Enhanced claim processing efficiency by streamlining workflows and implementing best practices.
- Collaborated with cross-functional teams to expedite complex claims investigations and resolutions.
- Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
- Developed in-depth understanding of insurance policies and procedures.
- Reduced claim resolution times with thorough documentation and timely follow-up.
- Investigated and resolved complex claims, ensuring adherence to policy guidelines and regulatory compliance.
- Maintained up-to-date knowledge of regulatory changes, ensuring company compliance and minimizing legal risks.
- Analyzed claim trends to anticipate potential issues and proactively adjust processing strategies.
- Streamlined data entry processes, improving efficiency in claim file management.
- Achieved high levels of accuracy in claim assessment, minimizing company's exposure to risk.
- Verified client information by analyzing existing evidence on file.
- Calculated adjustments, premiums and refunds.
- Maintained confidentiality of patient finances, records, and health statuses.
- Checked documentation for accuracy and validity on updated systems.
- Communicated effectively with staff members of operations, finance and clinical departments.
Assistant Manager
Firehouse Subs
09.2019 - 12.2022
- Assisted in daily operations to enhance customer service and satisfaction.
- Coordinated training sessions for new team members to ensure adherence to procedures.
- Implemented inventory management practices to reduce waste and improve efficiency.
- Developed staff schedules to optimize labor costs and maintain service levels.
- Supervised day-to-day operations to meet performance, quality and service expectations.
- Maintained a clean, safe, and organized store environment to enhance the customer experience.
- Monitored cash intake and deposit records, increasing accuracy, and reducing discrepancies.
- Oversaw daily cash reconciliations, ensuring accurate financial reporting and minimizing discrepancies.
- Improved customer satisfaction by addressing and resolving complaints promptly.
- Recruited, interviewed and hired employees and implemented mentoring program to promote positive feedback and engagement.
- Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
- Defined clear targets and objectives and communicated to other team members.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
- Trained personnel in equipment maintenance and enforced participation in exercises focused on developing key skills.
- Used industry expertise, customer service skills and analytical nature to resolve customer concerns and promote loyalty.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers.
- Opened and closed location and monitored shift changes to uphold successful operations strategies and maximize business success.
- Optimized scheduling to ensure adequate staffing during peak hours, improving service efficiency.
- Maintained compliance with health and safety regulations, ensuring safe environment for both staff and customers.
- Coached new employees, ensuring smooth onboarding process and quicker adaptation to their roles.
- Oversaw daily operations to maintain store cleanliness and organization.
- Improved customer satisfaction by resolving complaints and inquiries promptly.
- Scheduled staff shifts to ensure proper coverage during peak shopping hours without exceeding labor budgets.
- Assisted in recruiting, interviewing, hiring, and onboarding of new employees to maintain adequate staffing levels.
- Mentored junior staff members in their professional development by offering guidance/support in their assigned roles.
Team Member
Chicken Salad Chick
11.2021 - 01.2022
- Prepared and assembled menu items following company standards for quality and presentation.
- Maintained cleanliness and organization of workstations, ensuring compliance with health and safety regulations.
- Provided exceptional customer service by assisting guests with menu selections and addressing concerns.
- Collaborated with team members to ensure efficient operations during peak hours, enhancing overall service speed.
- Executed cash register transactions accurately, handling payments and providing change to customers promptly.
- Contributed to a positive team environment by fostering communication and cooperation among staff members.
- Kept work areas clean, organized, and safe to promote efficiency and team safety.
- Learned all required tasks quickly to maximize performance.
- Worked scheduled shifts and remained available to work during coworker absences, holidays, and busy periods.
- Contributed to team success by completing jobs quickly and accurately.
- Maintained productive, efficient approach to all tasks.
- Developed strong customer service and product knowledge skills to enhance individual and team performance.
- Operated register to process payments and collect cash payment for order totals.
- Worked different stations to provide optimal coverage and meet production goals.
- Addressed and resolved customer complaints in polite and professional manner.
- Contributed to a positive work environment by consistently demonstrating professionalism, adaptability, and strong interpersonal skills.
- Increased customer satisfaction with prompt and accurate responses to inquiries, addressing concerns, and resolving issues.
- Assisted with inventory counts and stocking of merchandise.
- Assisted customers in selecting merchandise best suited to needs.
- Broke down boxes and cartons, disposing of refuse in proper cardboard receptacles.
- Maintained clean and orderly store environment, ensuring pleasant shopping experience for customers.
- Ensured compliance with health and safety regulations, conducting regular checks and staff training.
- Frequently inspected production area to verify proper equipment operation.
Education
High School Diploma -
Salem High School
Salem, VA06.2019
Skills
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Data analysis
- Documentation research
- Claims processing
- Attention to detail
- Active listening
- Critical thinking
- Documentation processing
- Claims adjustment
- Organizing and prioritizing work
- Professionalism
- Analytical thinking
- Interpersonal skills
- Computer proficiency
- Relationship building
- Teamwork skills
- Verbal and written communication
- Adaptability and flexibility
- Effective communication
- Organizational skills
- Reliability
- Multitasking
- Problem-solving
- Claim amount calculations
- 10-key touch
- Data entry
- Prior authorization processing
- Insurance claim forms review
- Insurance coverage verification
- Denied claims identification
- Decision-making
- Interpersonal communication
- Coverage determination
Timeline
Claims Representative
Elevance Health
01.2023 - Current
Team Member
Chicken Salad Chick
11.2021 - 01.2022
Assistant Manager
Firehouse Subs
09.2019 - 12.2022
High School Diploma -
Salem High School